Cancer Risk for Women with Subsolid Lung Nodules Is Greater Than That for Men

Results from the US National Lung Screening Trial (NLST) show that women have a 50% higher chance of having hazy, lung nodules, which can result in a much higher risk of lung cancer compared to men.

The study demonstrated the value of Computed Tomography (CT) screening exams in reducing lung cancer mortality. The study was presented at the annual meeting of the Radiological Society of North America (RSNA 2015).

The nodules are classified as solid or subsolid based on how they appear in the CT scan, and their consistency is an indicator of lung cancer risk. The researchers used CT scans from the NLST, a large, randomized control study, which included more than 40% women. The researchers characterized all nodules detected by CT that measured between 4 mm and 30 mm, by consistency and used this information to calculate the relative risk of developing lung cancer for each nodule consistency subtype.

A total of 37.8% of people scanned had a positive screen at least once during the trial and women with ground-glass or part-solid nodules had a significantly higher relative risk of lung cancer than men with the same nodule type. The relative risk of lung cancer when solid nodules were detected in the CT scan was comparable for both sexes, and part-solid nodules had the highest predictive value of cancer in both sexes. Ground glass nodules had the lowest predictive value in men, and solid nodules in women.

The results suggest that women with ground glass nodules should undergo closer follow-up than men, however current guidelines for lung cancer screening do not account for differences in gender when managing nodules with different consistencies.

Lead author of the study, Phillip Boiselle, MD, Beth Israel Deaconess Medical Center (BIDMC; Boston, MA, USA), and Harvard Medical School (HMS; Boston, MA, USA), said, "We know there are differences in cancer risk among different lung nodule consistencies, but we were unaware of any published reports that looked at the differences in lung cancer risk for nodule subtypes between women and men. The main difference we found was that women were 50 percent more likely than men to have ground-glass nodules and, when these nodules were present, women had a substantially higher risk of developing lung cancer. By looking at the rate at which lung cancers grow on serial CT scans, we can develop a better understanding of how often to obtain follow-up CT scans in men and women.”

Related Links:
Beth Israel Deaconess Medical Center
Harvard Medical School